Background. The special status and position of older and oldest old in the therapeutic, diagnostic, and preventive activities of a dentist lead to a firm conviction of an urgent necessity and expediency of creating a new medical specialization — geriatric dentistry.

Aim. Based on many years of clinical experience and scientific research, including extensive use of high-tech oral prosthetics for older adults, to make the first attempt at creating an optimal therapeutic resource for a new medical specialization — geriatric dentistry.

Materials and methods. Examination and prosthetics were performed on 645 patients aged 60 to 85 years old, with various types of implantable prostheses in the period o 3 to 7 years after their implantation. In addition, 903 implantable prostheses and 3287 of their artificial supports (implants) were also examined.

Results. The mean age of patients who visited the orthopedic dentistry department for dental prosthetics was 64.72 ± 6.8 years old. As the main method of rehabilitation of older patients’ masticatory and speech apparatus, we have used implant-supported prosthesis with its digital transformation. Most of the patients underwent reasonably radical oral cavity preparation for prosthetics. The original state retention of the tissues of the implant bed ranged from 78.04 to 100%. At the same time, fixed structures of implantable prostheses were characterized by higher indicators. The preservation of the implants was from 96.8 to 100%, depending on the observation period.

Conclusion. The high values of implant and prosthesis retention rates, good condition of the peri-implant mucous membrane and bone in remote periods after prosthetics, as well as a high level of patient satisfaction and significantly higher achieved level of their quality of life, along with high medical and economic efficiency of the method, allow us to consider it a promising standard of geriatric dentistry. Thus, a modern therapeutic, or rather, rehabilitation, resource for effective pre-prosthetic preparation and implant prosthesis has been developed and justified, which is the optimal approach in geriatric dentistry.

Introduction. According to research, the condition of the oral cavity in older adults is one of the risk factors for the development of malnutrition; however, even with complete loss of teeth, malnutrition does not develop in all patients.

Objective. The aim of our study was to evaluate the prevalence of malnutrition in patients with tooth loss and the factors associated with a reduced risk of developing malnutrition in them.

Methods. Epidemiological study of the EVCALIPT random sample of individuals aged 65 years and older (n=396). Main study parameters: oral health assessment questionnaire, non-communicable chronic disease, nutritional assessment using the Mini Nutritional assessment, comprehensive geriatric assessment, blood count test.

Results. The prevalence of malnourishment does not depend on the number of remaining teeth and the use of dentures or implants (p>0.05). The main independent factors affecting the risk malnutrition in patients with oral frailty are complaints about difficulty with mastication [OR (95% CI) 2.100 (1.100–4.010)] and pronunciation of words [OR (95%CI) 2.203 (1.007–4.816)]. Maintaining high rates of grip strength [OR (95% CI) 0.314 (0.167–0.590)] and absence of depression [OR (95% CI) 0.408 (0.196–0.846)] are associated with a reduced risk of malnutrition in patients with oral frailty.

Conclusion. The fact of the absence of teeth or prostheses / implants does not lead to an increase in the risk of malnutrition in older adults. Complaints about mastication and words pronunciation difficulties are more significant contributors to the risk of malnutrition in this age group. High rates of grip strength and the absence of depression in patients with impaired chewing of food and pronunciation of words are associated with a diminished risk of malnutrition.

The article presents data on the incidence of oncological and precancerous diseases and cancer of the oral mucosa and the vermillion border of the lips in older, oldest old and long-livers (144 patients), being the patients of A.I. Yevdokimov Moscow State University of Medicine and Dentistry all of them underwent clinical examination and treatment at Therapeutic Dentistry and Oral Mucosa Diseases Department. Also, a review of the scientific literature and the regulatory framework for the management of patients, their routing and medical examination (506 sources of literature) was carried out. The tactics for the management of older patients with precancerous diseases and cancer of the oral mucosa and the vermillion border of the lips are analyzed.

Dental care is one of the types of medical care most demanded by various age groups of  patients. In the process of human aging, pathological and dystrophic changes develop in all organs and tissues, including the tissues of the maxillofacial region, which increases the need for patients to contact various specialists. Older and oldest-old often have several chronic somatic diseases and age-related mental characteristics, for the treatment of which several groups of drugs are used simultaneously. In geriatric dentistry, anesthesia should be applied taking into account polypharmacy, somatic and cognitive health. When deciding on a dosing regimen and assessing the risks of local anesthesia, it is important to consider not only the length of each visit to the dentist but also the total number of visits required to achieve dental health.

The article is aimed at improving the management of older and oldest-older in outpatient and inpatient medical facilities of Moscow. Represented algorithm of therapeutic and preventive measures allows the geriatrician, in accordance with CGA domains and possible clinical situations, to timely and efficiently draw up  a patient management plan based on the results of CGA and current clinical guidelines.

Introduction. Motoric cognitive risk (MCR) syndrome is a syndrome characterized by cognitive complaints or mild cognitive impairment (MCI) identified during tests and accompanied by slow gait but without dementia or autonomy decline. The concept of MCR is relatively new, and its natural course has not been sufficiently studied to date.

Objective. To estimate the prevalence of MCR, factors contributing to the risk of its development and the impact on mortality.

Methods. A prospective cohort Crystal study, random sample of individuals aged 65 and older. The total follow-up period was 9 years. Evaluation covered: gait speed, the Mini-Mental State Examination, chronic disease, blood pressure, lab tests.

Results. To diagnose the motor cognitive risk syndrome, the value of the gait speed was used, corresponding to the 2nd and 3rd quartiles — from 0.75 to 0.4 m/s. MCR was diagnosed in 16.7%. Type 2 diabetes was associated with an increased incidence of MCR [OR (95% CI) 7.275 (1.520–34.829)]. With an increase in systolic blood pressure (SBP) for every 30 mm Hg. the probability of detecting motoric cognitive risk syndrome increases by 6 times [OR (95% CI) 5.796 (1.388–24.200)]. After adjusting for sex, age, presence of type 2 diabetes, and blood pressure level, the addition of each component of the motoric cognitive syndrome increases the risk of all-cause death over 9 years of follow-up by 35% [HR (95% CI) 1.348 (1.001–1.814)].

Conclusion. The main chronic diseases associated with the development of MCR were type 2 diabetes and arterial hypertension. MCR is associated with a higher risk of mortality in older age, even with a slight decrease in gait speed. Gait speed within the 2nd and 3rd quarter may be a component of motoric cognitive risk syndrome.

In the presented article, the authors consider the problem of oral care for older patients with functional or cognitive impairments. This protocol outlines the process for assessing the oral cavity on patient’s admission and at each shift, explaining how to  inform the therapist of  any abnormalities when evaluating the oral health condition, and how to determine the extent to which oral care can be managed by the patient himself or herself. When providing oral care, measures are taken to prevent aspiration.